Data of the journals of Skin Research were organized and exhibited in April, 2003 to allow the search and access to the full texts of the literature that appeared in the journals. Since the search system was prepared in Japanese and English, the on-line journal of the Science of the Skin became accessible also to people in other countries. The method by which the database was constructed, the system, and security are summarized here. The construction of this system is considered to contribute to further release of information on dermatology to the public.

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Photosensitivity diseases include a variety of disorders with diverse pathomechanisms, etiologies, action spectra of light, and clinical manifestations. Based on the origin of responsible chromophores or photosensitizers, the disorders can be classified into endogenous and exogenous photosensitivity diseases. One of the representative diseases of the former is xeroderma pigmentosum, in which the responsible genes have been identified recently. The involvement of EB virus infection has been suggested for the development of hydroa vacciniforme. Solar urticaria and polymorphous light eruption may be immediate and delayed type of autoimmune photoallergic reaction, respectively. Quinolone antibiotics of oral use and topical nonsteroidal anti-inflammatory drugs are common causative agents of drug-induced photosensitivity.

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Dietary supplements in the market have become popular in the recent Japan, and the patients in dermatology are not infrequently use them. Aromatherapy is another problem for many dermatologists. Definition of dietary supplements, variety of supplements in the markets, and the food hygiene law and related laws were reviewed based upon our experience on the development of isoflavone tablets. Recent movement of “foods for specified health use (FOSHU)” and our database of the non-nutrient functional food factors were also introduced.

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During the last 30 years (1970-2000), I have engaged in studying clinical characteristics, pathophysiology and therapy of atopic dermatitis. Our group have then elucidated the following basic features of the disease: 1) the mode of inheritance of the disease is autosomal dominant; 2) type I allergic reactions often seen in the disease is a feature of concomitant respiratory atopy; 3) atopic dry skin histologically shows a mild eczematous change; 4) deranged barrier function of atopic skin is secondary to the eczematous inflammation of the disease; and 5) recalcitrant skin lesions of the disease quickly respond to common therapy when aggravating factors are excluded.

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A 36-year-old Japanese man handled DEMA in his work place from Jan. 7, 2002. He noticed pruritus on his hands at midnight of Jan. 19. Edematous erythema developed on his both hands on the morning of Jan. 20. He consulted his neighbouring physician and took sick leave until Jan. 24. He returned to work on Jan. 25 using new vinyl gloves. He handled DEMA again on the Feb. 21. On the next morning, edematous erythema develoed again on his both hands. He consulted to Kashiwara Municipal Hosital taking for precise medical examination. Patchtest results showed allergic reaction to DEMA 0.1% in pet.

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A 48-year-old woman presented with a 4-month history of generalized wheals in July 1997. They occurred daily on the whole body surfaces. The diagnosis of chronic urticaria was made, and antihistamines and systemic corticosteroids were given. Despite these treatments, wheals have not disappeared completely. The provoking factors including focal infections and collagen disease could not be identified. Next we tried an intradermal test with autologous serum and it showed a positive reaction. Functional autoantibodies to IgE were detected by basophil histamine release assays. Therefore, we diagnosed her wheals as autoimmune urticaria with circulating functional autoantibodies against IgE. An intermittent use of low-dose betamethasone in combination with antihistamines was partially effective. Acute exacerbations were relieved by intravenous methylprednisolone.

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A 54-year-old female with stage IIIb uterine cervical cancer was treated twice with transcatheter arterial infusion chemotherapy, ballooned occluded arterial infusion (BOAI). After the second treatment, brown pigmentation and painful subcutaneous induration appeared extensively on the hips. Histopathological examination of the subcutaneous induration of the right hip revealed melanophages in the upper dermis, irregular size adipocytes in subcutaneous adipose tissue, and the intralobular infiltration of inflammatory cells and foam cells. On the basis of these findings the patient was diagnosed as having adiponecrosis. Although drug delivery and retention in focal tissue can be increased by locally infusing anticancer agents, treatment with transcatheter arterial infusion in the pelvic region should be conducted with a special caution because of possible dermopathy in the hips.

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The patient was a 5-year-old boy. He went to a local dermatologist in December 2001 as erythema and blister formation were observed on his cheeks. When Myser^® (difluprednate) ointment was prescribed to him, the blisters temporarily disappeared but exacerbated later, and therefore he was admitted into our clinic. Edematous erythema and tense blisters were recognized on his face, trunk and extremities, and histopathological examination revealed subepidermal blisters. Immunofluorescence study showed linear deposits of IgG and C3 at the basal membrane zone of lesional skin. Indirect immunofluorescence microscopy revealed linear deposits on the dermal side using human skin treated with 1M NaCl as a substrate. In addition, a 290KDa protein band was recognized by an immunoblotting technique using dermal extract of normal human skin, and this condition was diagnosed as epidermolysis bullosa acquisita. This case was different from the classical type of epidermolysis bullosa acquisita in ways that the patient developed the disease in his childhood and he was quite responsive to the steroid treatment.

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Palmoplantar pustulosis is characterized by relapse of pustulosis, erythema and hyperkeratosis. It is sometimes difficult to manage the eruptions with topical steroid and vitamin D₃ treatments. The purpose of this study was to investigate the efficacy of narrow-band ultraviolet B (NB-UVB) phototherapy for palmoplantar pustulosis. Patient : The mean age of the patients was 60.5. The affected period was 10.3 years. The following protocol of NB-UVB therapy was used. Treatment was performed twice a week starting with 0.3J/cm². If the initial dose tolerated, a 20 percent incremental increase of the previous dose is used at each visit. All 4 patients responded to NB-UVB therapy. Based on the small number of patient, this result only suggested that NB-UVB therapy would be effective and safe treatment for palmoplantar pustulosis. Further study should be required in large scale to confirm the efficacy and the safety.

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We encountered a 95-year old female with disseminated superficial porokeratosis with squamous cell carcinoma. The patient had multiple round keratotic brown maculae on almost her entire body surface from a young age. A tumor appeared on the macula of her right leg four months ago, and then it increased in size and easily bled with a slight touch. Histopathologically, the tumor nest grew into the dermis from epidermis irregularly and the arrangement of the tumor cells was disorderly with a high level of dysplasia. We performed a skin biopsy from another brown macula and ascertained the existence of cornoid lamella. The tumor was thus diagnosed a squamous cell carcinoma from disseminated superficial porokeratosis. The tumor was surgically resected. This case is presented along with a discussion of the malignant change of the skin in the porokeratosis.

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We reported a case of lichen planus due to dental metal compounds. A 55-year-old female had suffered from itchy eruptions on her forehead and back for two years. She was treated with topical medicaments and internal medicines. However, her symptoms had not been improved. Then she suffered from painful lesions on buccal mucosa for eight months. The histopathological diagnosis was lichen planus of the buccal mucosa. The result of patch tests showed a positive reaction to gold sodium thiosulfate 0.5%pet.. The painful lesions on her buccal mucosa and itchy eruptions on her forehead and back became less distinct after removing dental metals containing gold.

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We report a case of 70-year-old woman with Sjögren’s syndrome whom it was thought to be associated with cutaneous polyarteritis nodosa.
She developed a gradual progression of dry mouth after partial replacement of her teeth at the age of 45 years. She presented in 1996, at the age of 65, with three year history of dry eyes. In June 2001, she was aware of edema and pain in both lower legs. At the same time, indurated erythemas and ulcers are seen on her lower legs. Pain, erythemas and ulcers expanded, and she was admitted to our hospital in September, 2001.
Lip biopsy revealed infiltration of lymphocytes in the salivary glands. Schirmer test was positive and sialography revealed marked destructive changes in the acinus lobules. These features justified the diagnosis of Sjögren’s syndrome.
Laboratory data revealed positive anti-SS-A antibodies and absence of MPO-ANCA. Rheumatoid factor was positive, and anti-nuclear antibody was × 640 (speckled type).
Biopsy from the skin lesion disclosed leukocytoclastic vasculitis of small arteries in the fat tissue.
Neurological examination revealed mononeuritis multiplex. These findings were compatible with the diagnosis of polyarteritis nodosa.

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The somatostatin analogue, octreotide, has been proposed as a promising therapeutic agent for abnormal gastrointestinal motility. We here in reported two cases of systemic sclerosis associated with massive pseudoobstruction, in which octreotide administration was efficacious agonist against gastrointestinal symptoms. Treatment with subcutaneous injection, octreotide 100μg daily, remarkably relieved the symptoms of pseudoobstruction. Thereafter, the interval of the injection was gradually prolonged to biweekly administration as a maintenance therapy. The treatment was well tolerated and able to maintain the digestive functions for a long period. The treatment with octreotide may be worth trying to improve clinical symptoms of pseudoobstruction in patients with systemic sclerosis.

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A 59-year-old man who underwent excision of a chordoma of his hip 11years ago, had 10 times of excision for local recurrences of the chordoma until June, 1999. We cut off a cutaneous tumor on his head which appeared August, 1999, and based on the histopathological and immunohistochemical findings, we concluded that the head lesion was a skin metastasis of the chordoma.

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Keloid is rarely seen on the umbilicus. We present a 48-year-old female patient with umbilical keloid that occurred after laparoscopically assisted vaginal hysterectomy. Echo and computed tomography of the abdomen revealed that the tumor extended from the dermis to the peritoneum. Extensive resection of the tumor including the peritoneum resulted in no recurrence at 4 years after the operation. Our case could suggest that umbilical keloid may be developed after laparoscopic surgery.

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A 4-year-old girl was seen with many papules on the right axilla, which had been previously treated with surgical resection under the diagnosis of lymphangioma. A subcutaneous nodule was present beneath the lesion composed of gathered papules. Histopathologic findings showed numerous dilated lymphantic vessels that were unusually located both on the deep dermis and fatty tissue. Complete resection of the tumor and fascia resulted in no recurrence.

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